Post-OP Pain Flashcards
Clinical assessment
Subjective - Ask them to grade their pain
Objective - tachycardia, tachypnoea, hypertension, sweating, flushing.
Consequences of poor pain control.
Slower recovery.
Reluctancy to mobilise
Inadequate ventilation as they might not breath heavy enough
Atelectasis
Hospital-acquired pneumonia
WHO analgesic ladder
Simple analgesics.
Paracetamol
NSAIDs
Side effects of NSAIDs
I-GRAB
Interactions iwth other medications
Gastric ulceration
Renal impairment
Asthma sensitivity
Bleeding risk
Opiate analgesics
Weak - Codeine
Strong -Morphine, oxycodone, fentanyl.
Side effects of opiate analgesics
Constipation
Nausea
Sedation and confusion
Respiratory depression
Tolerance and dependence
Why should you avoid weak and strong opiates in combination?
They competitively inhibit one another
What should be done if PRN opiates are frequently called for?
Check 24h opiate req and consider titration into a regular basal dose of modified-release preparations.
What strong opioid should be used in renal impairment?
Oxycodone or fentanyl instead of morphine
What is patient controlled analgesia?
IV pump that the patient controls.
This provides a bolus dose of an analgesic on press.
Advantages of PCA
Provides analgesia tailored to the patient’s req
Safe and the risk of OD is negligible
Can accurately record how much opioid is being administered
Disadvantages of PCA
Can be cumbersom and prevent the patient mobilising
Not appropriate for those with poor manual dexterity or learning difficulties/altered mental status
How is neuropathic pain commonly described?
Shooting or stabbing
Electrical shock
When might you encounter neuropathic pain?
After orthopaedic or vascular surgery
Particularly in amputees
